Trauma, PTSD, Stress, Mental Health and Yoga

Trauma literally means a physical injury, or a deeply distressing, disturbing emotional event. Emotional or psychological trauma is often the result of a physical injury, or an overwhelming amount of stress that exceeds one’s ability to cope or integrate the emotions involved with that experience; it is the result of a real or perceived threat to life, or sexual violence. A traumatic event involves one experience, or repeating events with the sense of being overwhelmed that can be delayed by weeks, years, or even decades as the person struggles to cope with the immediate circumstances, eventually leading to serious, long-term negative consequences.

If the symptoms persist for more than one month, it is termed Post Traumatic Stress Disorder (PTSD). Most people having experienced a trauma event will not progress to PTSD. Assault-based trauma victims are more likely to develop PTSD. People who experience non-assault based trauma such as witnessing trauma, accidents, and fire events, are less likely to develop PTSD. Children, especially those less than 10 years of age, are less likely to experience PTSD after trauma. War veterans are more at risk for PTSD.

Trauma is a very common occurrence; according to an estimate, at least 1 in every 4 adults has suffered trauma at one or the other time in life. It is also one of the top five most costly health problems. This post discusses emotional or psychological trauma.

History

Trauma is as old as humans, although the diagnosis of post traumatic stress disorder or PTSD only made it into the Diagnostic and Statistical Manual of Mental Disorders (DSMV) in 1980. War, rape, natural disasters and abuse are as old as humans, and so is PTSD. Called soldier’s heart in the American Civil War, shell shock in the First World War, war neurosis in WWII, combat stress reaction in the Vietnam War, sometimes loosely labelled nervous breakdown, diagnosis that was gradually reformulated as PTSD.

There fell in this battle of Marathon, on the side of the barbarians, about six thousand and four hundred men; on that of the Athenians, one hundred and ninety-two. Such was the number of the slain on the one side and the other. A strange prodigy likewise happened at this fight. Epizelus, the son of Cuphagoras, an Athenian, was in the thick of the fray, and behaving himself as a brave man should, when suddenly he was stricken with blindness, without blow of sword or dart; and this blindness continued thenceforth during the whole of his after life. The following is the account which he himself, as I have heard, gave of the matter: he said that a gigantic warrior, with a huge beard, which shaded all his shield, stood over against him; but the ghostly semblance passed him by, and slew the man at his side. Such, as I understand, was the tale which Epizelus told.

– Herodotus (6.117 – Rawlinson translation)

The ancient Greek historian Herodotus describes that warrior Epizelus experiences hysterical blindness, possibly an extreme form of PTSD. The Greek playwright Sophocles has devoted Ajax and Philoctetes to devastating descriptions of the post-battle breakdowns. The hero Ajax kills hundreds of farm animals, believing them to be his commanding officers, and finally commits suicide by throwing himself on the point of his sword. “What should I do?” cries the despairing Ajax. “The gods hate me, the Trojans loathe me, the Greeks despise me!” The victims of PTSD are known to be at increased risk for homicide and suicide even today. Chaturanga (four limbs of the armed forces), or chatur, is an ancient two player Indian strategy game which is the common ancestor of the board games chess, shogi, makruk, xiangqi and janggi. Four player version was called chaturaji. It was described as shataranja by the Arab scholar Abu al-Hasan ‘Alī al-Mas’ūdī as a tool for military strategy, but also for reliving old battles, perhaps as a form of exposure therapy!

A brief recapitulationof history of PTSD is:

3000 BC (? 8000 B.C., or still older) – The horrendous combat events described in the Mahabharata and the demeanor and death of the main warrior characters such as Jayadratha graphically illustrate the trauma and symptoms now recognized as PTSD.

1900 BC – Egyptian physicians report hysterical reaction.

8 Century BC – Homer in The Odyssey describes flashbacks and survivor’s guilt.

730 BC – Homer’s great epic, The Iliad narrates a series of harrowing episodes of battle stress that were experienced by the ancient Hellenic combatants. He clearly paints the picture of the horror of war and trauma of combat. Achilles, the archetypal warrior, cries out in anguish and rage at the death and mutilation of his friend Patroklos.

490 BC – Herodotus writes of a soldier going blind after witnessing the death of a comrade next to him.

3 -5 BC – Jataka stories in Budhism

1597 – Shakespeare vividly describes war sequel in King Henry IV

1600 – Samuel Pepys describes symptoms in survivors of the great fire of London.

1952 – Carl Jung analyses the psychological component of story of Job in Bible

1980 – PTSD becomes a diagnostic category in DSM

Careful research and documentation of PTSD began in earnest after the Vietnam War. The National Vietnam Veterans Readjustment Study estimated in 1988 that the prevalence of PTSD in that group was 15.2% and that 30% had experienced the disorder at some point since returning from Vietnam.

Cause

Stress, trauma or tension can happen due to many causes — a difficult or failed relationship, a financial hardship, a car accident, violence, an abuse, to name just a few. There is frequently a violation of the person’s familiar ideas about the world and of their human rights, putting the person in a state of extreme confusion and insecurity. This is also seen when a person feels violated or betrayed or disillusioned by some institution in unforeseen ways. Upsetting emotions, frightening memories, or a sense of constant danger may be the result. For most people, these symptoms are short-lived. They may last for several days or even weeks, but they gradually disappear.

But in some cases, the symptoms don’t decrease – one does not improve with each passing day. In fact, one may start to feel worse. The trauma may reflect in the body through the central nervous system. It may manifest as both emotional/ psychological as well as physical symptoms, ranging from flashbacks and anxiety, sensori-motor reactions as intrusive images, sounds, smells, body sensations, physical pain, constriction, numbing and even deep muscle patterns. These persisting trauma symptoms have the ability to derange one’s mental, psychological, biological, and social health.

An event will most likely lead to trauma if:

it is unexpected,

one is not prepared for it,

feels unable to prevent it;

happens repeatedly,

someone is intentionally cruel, or,

if it happened in childhood.

This can also be caused by one-time events, such as a horrible accident, a natural disaster, or a violent attack.

In case of a perceived or real threat, the first thing that happens is ‘sympathetic stimulation’, preparing the body for ‘fight or flight response. When the situation worsens further, in addition to changes in CNS, the ‘primitive dorsal vagus‘ elicits immobilization or ‘freeze‘ behavior; ventral vagus is connected with empathy, social communication and self-soothing behavior.

Neuroendocrinology of Trauma

PTSD symptoms may result when a traumatic event causes an over-reactive adrenaline response, which creates deep neurological patterns in the brain. These patterns can persist long after the event that triggered the fear, making an individual hyper-responsive to future fearful situations. During traumatic experiences the high levels of stress hormones secreted suppress hypothalamic activity that may be a major factor toward the development of PTSD.

The hypothalamic-pituitary-adrenal (HPA) axis is responsible for coordinating the hormonal response to stress. In PTSD, there is a maladaptive learning pathway to fear response through a hypersensitive, hyperreactive, and hyperresponsive HPA axis.

Low cortisol levels may predispose individuals to PTSD. People who suffer from PTSD have chronically low levels of serotonin, which contributes to the commonly associated behavioral symptoms such as anxiety, ruminations, irritability, aggression, suicidality and impulsivity. Serotonin also contributes to the stabilization of glucocorticoid production.

Hyperresponsiveness in the norepinephrinesystem can be caused by continued exposure to high stress. Overactivation of norepinephrine receptors in the prefrontal cortex can be connected to the flashbacks and nightmares. A decreased awareness of the current environment prevents the memory mechanisms in the brain from associating the flashback with the current environment.

Majority of reports indicate people with PTSD have elevated levels of corticotropin-releasing hormone, lower basal cortisol levels, and enhanced negative feedback suppression of the HPA axis by dexamethasone.

Neuro-anatomy of Trauma

Three areas of the brain in which function may be altered in PTSD have been identified:

prefrontal cortex,

amygdala, and

hippocampus.

PTSD is considered a syndrome of deficient extinction ability. The amygdala is a heterogeneous brain structure implicated in processing of emotions and storing the emotional aspects of memories. The amygdalocentric model of PTSD proposes that it is associated with hyperarousal of the amygdala and insufficient top-down control by the mPFC (medial prefrontal cortex) and the hippocampus in particular during extinction. Studies suggest that therapeutic strategies that enhance IGF2/IGFBP7 signalling and adult neurogenesis might be suitable to treat diseases linked to excessive fear memory such as PTSD.

Amygdala can also pre-empt neo-cortex through amygdala hijack; an amygdala hijack exhibits three signs: strong emotional reaction, sudden onset, and post-episode realization if the reaction was inappropriate.In human studies, the amygdala has been shown to be strongly involved in the formation of emotional memories, especially fear-related memories. During high stress times, the hippocampus, which is associated with the ability to place memories in the correct sequence and context of space and time, and with the ability to recall the memory, is suppressed. This suppression is hypothesized to be the cause of the flashbacks that often affect people with PTSD. When someone with PTSD undergoes stimuli similar to the traumatic event, the body perceives the event as occurring again because the memory was never properly recorded in the person’s memory.

The maintenance of the fear involved with PTSD has been shown to include the HPA axis, the locus coeruleus-noradrenergic systems, and the connections between the limbic system and frontal cortex. The HPA axis that coordinates the hormonal response to stress, which activates the LC-noradrenergic system, is implicated in the over-consolidation of memories that occurs as a result of trauma. This over-consolidation increases the likelihood of one’s developing PTSD. The amygdala is responsible for threat detection and the conditioned and unconditioned fear responses that are carried out as a response to a threat.

The LC-noradrenergic system has been hypothesized to mediate the over-consolidation of fear memory in PTSD. High levels of cortisol reduce noradrenergic activity, and because people with PTSD tend to have reduced levels of cortisol, it is proposed that individuals with PTSD fail to regulate the increased noradrenergic response to traumatic stress. It is thought that the intrusive memories and conditioned fear responses to associated triggers is a result of this response. Neuropeptide-Y has been reported to reduce the release of norepinephrine and has been demonstrated to have anxiolytic properties in animal models. Studies have shown people with PTSD demonstrate reduced levels of NPY, possibly indicating their increased anxiety levels.

The basolateral nucleus (BLA) of the amygdala is responsible for the comparison and development of associations between unconditioned and conditioned responses to stimuli, which results in the fear conditioning present in PTSD.

The BLA activates the central nucleus (CeA) of the amygdala, which elaborates the fear response, (including behavioral response to threat and elevated startle response). Descending inhibitory inputs from the medial prefrontal cortex (mPFC) regulate the transmission from the BLA to the CeA, which is hypothesized to play a role in the extinction of conditioned fear responses.

The Vagus Nerve

The vagus nerve (X cranial nerve) is a primary component of the autonomic nervous system. The word vagus means “wandering” in Latin. The words vagabond, vague, and vagrant come from the same root. The vagus nerve is known as the wandering nerve because it has multiple branches. This is one of the major nerves that goes to the brain. By stimulating the nerves, you can cause upstream changes in the brain without having to go into the brain.

Polyvagal theory outlines the structure and function of the two distinct branches of the vagus, both of which originate in the medulla. Each branch is associated with a different adaptive behavioral strategy, both of which are inhibitory in nature via the parasympathetic nervous system (PNS). The sympathetic-adrenal system is involved in mobilization behavior; vagus nerve acts opposite to this. According to polyvagal theory, these opposing systems are phylogenetically arranged.

Dorsal Vagal Complex (DVC)

The dorsal branch of the vagus originates in the dorsal motor nucleus and is considered the phylogenetically older branch. This branch is unmyelinated and exists in most vertebrates. Also known as the ‘vegetative vagus’, it is associated with primal survival strategies of primitive vertebrates, reptiles, and amphibians. Under great stress, these animals `freeze` when threatened, conserving their metabolic resources.

The dorsal vagal complex (DVC) provides primary control of sub-diaphragmatic visceral organs, such as the digestive tract. Under normal conditions, the DVC maintains regulation of these digestive processes. However, prolonged disinhibition can be lethal for mammals, as it results in apnea and bradycardia.

Ventral Vagal Complex (VVC)

A more sophisticated system with increased neural complexity evolved in mammals. This enriched behavioral and affective responses to an increasingly complex environment. The ventral branch of the vagus originates in the nucleus ambiguus and is myelinated to provide more control and speed in responding. It is also known as the “smart vagus” as it is associated with the regulation of sympathetic “fight or flight” behavior in the service of social affiliative behaviors. These behaviors include social communication and self-soothing and calming. In other words, this branch of the vagus can inhibit or disinhibit defensive limbic system, depending on the situation. The VVC provides primary control of supra-diaphragmatic visceral organs, such as the esophagus, bronchi, pharynx, larynx and heart. When vagal tone to the heart’s pacemaker is high, a baseline or resting heart rate is produced. In other words, the vagus acts as a restraint, or brake, limiting heart rate. However, when vagal tone is removed, there is little inhibition to the pacemaker, and so rapid mobilization (“fight/flight”) can be activated in times of stress, but without having to engage the sympathetic-adrenal system, as activation comes at a severe biological cost.

Vagal Tone

In order to maintain homeostasis, the central nervous system responds constantly, via neural feedback, to environmental cues. Stressful events disrupt the rhythmic structure of autonomic states, and subsequently, behaviors. Amplitude of respiratory sinus arrhythmia (RSA) is a good index of PNS activity via the cardiac vagus. That is, RSA is a measurable, noninvasive way to see how the vagus modulates heart rate activity in response to stress. This method is useful to measure individual differences in stress reactivity.

Research has shown that amplitude of RSA is an accurate indicator of the efferent influence of the vagus on the heart, and is widely used for this purpose. Since inhibitory effects of the VVC branch of the vagus allow for a wide range of adaptive, prosocial behaviors, it has been theorized that individuals with greater vagal tone are able to exhibit a greater range of such behaviors. On the other hand, decreased vagal tone is associated with illnesses and medical complications that compromise the CNS. These complications may reduce one’s capacity to respond to stress appropriately.

the ‘rest, digest and relax’ function of the Parasympathetic Nervous System never gets a chance to act

digestive system is impaired; endocrine system is disrupted causing imbalance of growth hormones and reproductive hormones

the body pH becomes acidic and promotes inflammation.

All of this leads to a variety of secondary illnesses including high blood pressure, cardiovascular disease, gastrointestinal problems, respiratory illnesses, immune disorders, to name just a few.

Trigeminal Nerve

The trigeminal nerve (V Cranial Nerve) is the fifth paired cranial nerve. It is also the largest cranial nerve. It is responsible for sensation in the face and motor functions such as biting and chewing. Its name derives from the fact that each trigeminal nerve (one on each side of the pons) has three major branches: the ophthalmic nerve , the maxillary nerve , and the mandibular nerve. The ophthalmic and maxillary nerves are purely sensory, and the mandibular nerve has sensory (or “cutaneous”) and motor functions.The trigeminal nerve originates from three sensory nuclei (mesencephalic, principal sensory, spinal nuclei of trigeminal nerve) and one motor nucleus(motor nucleus of the trigeminal nerve) extending from the midbrain to the medulla.

The ophthalmic, maxillary and mandibular branches leave the skull through three separate foramina:

superior orbital fissure,

foramen rotundum and

foramen ovale.

The ophthalmic nerve carries sensory information from the scalp and forehead, the upper eyelid, the conjunctiva and cornea of the eye, the nose (including the tip of the nose, except alae nasi), the nasal mucosa, the frontal sinuses and parts of the meninges (the dura and blood vessels). The maxillary nerve carries sensory information from the lower eyelid and cheek, the nares and upper lip, the upper teeth and gums, the nasal mucosa, the palate and roof of the pharynx, the maxillary, ethmoid and sphenoid sinuses and parts of the meninges. The mandibular nerve carries sensory information from the lower lip, the lower teeth and gums, the chin and jaw (except the angle of the jaw, which is supplied by C2-C3), parts of the external ear and parts of the meninges. The mandibular nerve carries touch-position and pain-temperature sensations from the mouth. Although it does not carry taste sensation (the chorda tympani is responsible for taste), one of its branches—the lingual nerve—carries sensation from the tongue.

The two basic types of sensation are touch-position and pain-temperature. Touch-position input comes to attention immediately, but pain-temperature input reaches the level of consciousness after a delay. Touch-position information is generally carried by myelinated (fast-conducting) nerve fibers, and pain-temperature information by unmyelinated (slow-conducting) fibers. Touch-position and pain-temperature sensations are processed by different pathways in the central nervous system. This hard-wired distinction is maintained up to the cerebral cortex. Within the cerebral cortex, sensations are linked with other cortical areas.

The complex processing of pain-temperature information in the thalamus and cerebral cortex (as opposed to the relatively simple, straightforward processing of touch-position information) reflects a phylogenetically older, more primitive sensory system. The detailed information received from peripheral touch-position receptors is superimposed on a background of awareness, memory and emotions partially set by peripheral pain-temperature receptors.

As the trigeminal nerve has reciprocal projections to the nucleus tractus solitarius, the locus coeruleus, and the reticular formation, its role is implicated in mood regulation and anxiety disorders.

Pelvic Splanchnic Nerves

Pelvic splanchnic nerves or nervi erigentes are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the hindgut. The parasympathetic nervous system is referred to as the craniosacral outflow; the pelvic splanchnic nerves are the sacral component. They are in the same region as the sacral splanchnic nerves, which arise from the sympathetic trunk and provide sympathetic efferent fibers. They contribute to the innervation of the pelvic and genital organs. The nerves regulate the emptying of the urinary bladder, control opening and closing of the internal urethral sphincter, influence motility in the rectum as well as sexual functions like erection.They contain both preganglionic parasympathetic fibers as well as visceral afferent fibers. In the distal 1/3 of the transverse colon, and through the sigmoid and rectum, and the cervix in females, the pelvic splanchnic nerves supply parasympathetic function, including transmitting the sensation of pain.The proximal 2/3 of the transverse colon, and the rest of the proximal gastrointestinal tract is supplied its parasympathetic fibers by the vagus nerve.

Symptoms of trauma

Following trauma, people react in different ways, experiencing a wide range of physical and emotional reactions. Traumatic event is an ABNORMAL event and all reactions to it are NORMAL reactions.

Common physical symptoms of trauma can be: insomnia or nightmares, easy startling, racing heart, aches and pains, fatigue, difficulty concentrating, edginess and agitation, muscle tensions. Common emotional and psychological symptoms of trauma can be: shock, denial, or disbelief, anger, irritability, mood swings, guilt, shame, self-blame, feeling sad or hopeless, confusion, difficulty concentrating, anxiety and fear, withdrawing from others, feeling disconnected or numb. People who have lost a loved one may go through a grieving process. These symptoms may last from a few days to a few months, gradually fading as you process the trauma. But even when you’re feeling better, you may be troubled from time to time by painful reminders.

Diagnosis

Trauma, specifically Post Traumatic Stress Disorder (PTSD), is diagnosed based on signs and symptoms, a physical examination and a thorough psychological evaluation.

PTSD Mnemonic

E – Event/experience (threatening to life or physical integrity of self or others)

R – Re-experience (flashbacks, nightmares etc)

A – Arousal (anxiety, startling, hyper-vigilance, irritability)

A – Avoidance (of things, places, images etc. reminiscent of event)

D – Duration of more than one month

Criteria for PTSD are given in Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

DSM criteria for PTSD

Diagnosis of PTSD requires exposure to an event that involved or held the threat of death, violence or serious injury. Your exposure can happen in one or more of these ways:

You experienced the traumatic event.

You witnessed, in person, the traumatic event.

You learned someone close to you experienced or was threatened by the traumatic event.

You are repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to the scene of traumatic events).

You experience one or more of the following signs or symptoms after the traumatic event:

You relive experiences of the traumatic event, such as having distressing images and memories.

You have upsetting dreams about the traumatic event.

You experience flashbacks as if you were experiencing the traumatic event again.

You experience ongoing or severe emotional distress or physical symptoms if something reminds you of the traumatic event.

In addition, for more than one month after the traumatic event you may:

Try to avoid situations or things that remind you of the traumatic event

Not remember important parts of the traumatic event

View yourself, others and the world in a negative way

Lose interest in activities you used to enjoy and feel detached from family and friends

Feel a sense of emotional numbness, feel irritable or have angry or violent outbursts

Engage in dangerous or self-destructive behavior

Feel as if you’re constantly on guard or alert for signs of danger and startle easily

Have trouble sleeping or concentrating

Your symptoms cause significant distress in your life or interfere with your ability to go about your normal daily tasks.

For children younger than 6 years old, signs and symptoms may include:

Reenacting the traumatic event or aspects of the traumatic event through play

Frightening dreams that may or may not include aspects of the traumatic event

Seeking professional help

Everyone heals at his or her own pace and recovering from a traumatic event may take time. Professional help is indicated if even after months one is still experiencing symptoms.

One should seek professional help if one is:

Suffering from great fear, anxiety, or depression

Unable to form close, satisfying relationships

Having trouble functioning normally at home or work

Experiencing disturbing memories, nightmares, or flashbacks

Trying to avoid more and more things that remind you of the trauma

Feels emotionally numb and disconnected from others

Using alcohol or drugs to feel better

Trauma treatment in Modern Medicine

Trauma freezes you in a state of fear and hyper-arousal and disrupts natural equilibrium. In PTSD, nervous system gets stuck in that traumatic state. Successful trauma treatment must re-establish your sense of safety and remove this imbalance.

Trauma treatment and healing entails:

Discharging ‘fight-or-flight’ or ‘freeze’ emotions

Processing trauma-related memories and feelings

Learning how to regulate strong emotions

Rebuilding the ability to trust other people

Different treatment options available in Modern Medicine are:

Psychotherapy

Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with trauma. Some types of psychotherapy used in trauma treatment include:

Validation. Validation of the devastating impact of their initial trauma is the most healing thing. This relieves the burden of shame and guilt often associated with abuse.

Exposure therapy. This behavioral therapy helps you safely face what you find frightening so that you can learn to cope with it effectively. One approach to exposure therapy uses “virtual reality” programs that allow you to re-enter the setting in which you experienced trauma.

Somatic experiencing uses body’s unique ability to heal itself. This focuses on bodily sensations rather than thoughts and memories of the traumatic event; that gets you in touch with pent-up trauma-related energy and tension. Natural survival instincts take over from there, safely releasing this energy through various ways of expression like shaking, crying, and other forms of physical release.

EMDR (Eye Movement Desensitization and Reprocessing) is psychotherapy that emphasizes disturbing memories as the cause of psychopathology. This 8-phase therapy incorporates some elements of CBT with eye movements or other forms of rhythmic, left-right stimulation. These back-and-forth eye movements unfreeze traumatic memories, and resolve them.

Cognitive-behavioral therapy (CBT) helps you process and evaluate your thoughts and feelings about a trauma. Cognitive-behavioral therapy doesn’t treat the physiological effects of trauma; however, it can be helpful when used in addition to a body-based therapy such as somatic experiencing or EMDR.

Expressive therapy. Expressive therapies, expressive arts therapy or creative arts therapy, is the use of tactile, visual or other creative arts like Art Therapy, Music Therapy, Dance/ Movement Therapy, Drama Therapy, Poetry Therapy, Play Therapy, Sandplay Therapy, Multimodal Therapy etc as a form of therapy. The process of creation is emphasized rather than the final product. Expressive therapy can heal through use of imagination and the various forms of creative expression.

Medications. Most medications do not have enough evidence to support their use. Symptomatic medication – anti-anxiety, anti-depression, sedatives, may be prescribed for emotional trauma patients. Several types of medications can help improve symptoms of trauma:

Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by FDA.

Anti-anxiety medications. These drugs also can improve feelings of anxiety and stress for a short time. Because these medications have the potential for abuse, they are not usually taken long term.

Prazosin. If symptoms include insomnia or recurrent nightmares prazosin (Minipress) may help. It may reduce or suppress nightmares in many people with trauma.

Nerve Stimulators

Vagal Nerve Stimulator (VNS).Scientists have discovered that artificial Vagus Nerve Stimulation (VNS), through electrical impulses via a surgically implanted pacemaker like device, shows promising results in reducing depression, anxieties and even conditions such as epilepsy, obesity, PSTD, OCD(obsessive-compulsive disorder) and PD (Panic Disorder). VNS has also shown positive effects in promoting weight-loss as the signals to the brain of ‘fullness’ are more easily transmitted. The VNS device is sometimes referred to as a ‘pacemaker for the brain’. It is placed under the skin on the chest wall and a wire runs from it to the vagus nerve in the neck. VNS Therapy is designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve. These pulses are supplied by a device something like a pacemaker. This is approved by FDA.

Trigeminal Nerve Stimulator (TNS). TNS can be delivered via the non-invasive external trigeminal nerve stimulation (eTNS) system or the minimally-invasive subcutaneous trigeminal nerve stimulation (sTNS) system for problems including epilepsy, depression, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD) Lennox-Gastaut syndrome (LGS), traumatic brain injury (TBI) and ADHD (attention-deficit/hyperactivity disorder). It works by sending signals in through the trigeminal nerve into the brain stem. From there, the signals can influence the activity in the centers of the brain that produce serotonin and norephinephrine, and also send signals to the anterior cingulate, the amygdala, the areas of the brain that are very important for things like emotional regulation and anxiety. This is still an investigational method.

Trauma self-help strategy

Break the cycle. When you feel anxious, take a brisk walk or jump into a hobby to re-focus.

Do not stay alone. Isolation makes things worse. Connecting to others will help you heal; so, make an effort to maintain your relationships and avoid spending too much time alone.

Support. Ask for the support if you need. Turn to a trusted family member, friend or a professional counselor.

Participate. Try to do normal things with other people that have nothing to do with the traumatic experience. Make the effort to reconnect.

Support group. Join a group of people with similar problems. Being with others who are facing the same problems can help reduce your sense of isolation, and hearing how others cope can help inspire you.

Volunteer. Volunteering can be a great way to challenge the sense of helplessness that often accompanies trauma. Remind yourself of your strengths and reclaim your sense of power by comforting or helping others.

Stay grounded. Have a structured schedule to follow. Stick to a daily routine, with regular times for waking, sleeping, eating, working, and exercise. Make sure to schedule time for relaxing and social activities, too. Break big tasks into smaller, manageable steps. Take pleasure from the accomplishment of achieving something, even it’s a small thing.

Find activities that make you feel better and keep your mind occupied (reading, taking a class, cooking, playing with your kids or pets), so you’re not dedicating all your energy and attention to focusing on the traumatic experience.

Allow yourself to express your feelings . Acknowledge your feelings about the trauma as they arise and accept them. Accepting your feelings is part of the grieving process and is necessary for healing.

You may want to go outdoors and find a peaceful place.

Take care of your health. A healthy body increases your ability to cope with stress from a trauma. Get plenty of sleep. After a traumatic experience, worry or fear may disturb your sleep patterns. A lack of sleep can make your trauma symptoms worse and make it harder to maintain your emotional balance. Go to sleep and get up at the same time each day and aim for 7 to 9 hours of sleep each night.

Avoid alcohol and drugs as their use can worsen your trauma symptoms and exacerbate feelings of depression, anxiety, and isolation.

Exercise regularly.Regular exercise boosts serotonin, endorphins, and other feel-good brain chemicals. It also boosts self-esteem and helps to improve sleep. For maximum results, aim for 30 to 60 minutes of activity on most days.

Eat a well-balanced diet.Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. While you may be drawn to sugary foods for the quick boost they provide, complex carbohydrates are a better choice. Foods rich in certain omega-3 fats—such as salmon, walnuts, soybeans, and flaxseeds—can give your mood a boost.

Reduce stress. Making time for rest and relaxation will help you bring your life back into balance. Try relaxation techniques such as meditation, yoga, or deep breathing exercises. Schedule time for activities that bring you joy—favorite hobbies or activities with friends, for example.

Helping someone in trauma

Helping a loved one who has suffered a traumatic or distressing experience may be tough, but your support can be a crucial factor in their recovery.

Offer support to get back into a normal routine. That may mean help with collecting groceries or housework, for example, or simply being available to talk or listen.

Don’t pressure your loved one into talking but be available when they want to talk.

Help your loved one to socialize and relax. Encourage them to participate in physical exercise, seek out friends, and pursue hobbies and other activities that bring them pleasure. Take a fitness class together or set a regular lunch date with friends.

Don’t take the trauma symptoms personally. Your loved one may become angry, irritable, withdrawn, or emotionally distant. This may be a result of the trauma and may not have anything to do with you or your relationship.

Helping a child

Following trauma, a child may show regression, tendency to take the blame, disturbed sleep or helplessness.

Regression. Many children may regress to an earlier stage, when they felt safer and more cared for. Younger children may wet the bed or want a bottle; older children may fear being alone. It’s important to be patient and comforting if your child responds this way.

Take the blame. Younger children tend to think that it must be their fault. Be sure the child understands that he did not cause the event.

Sleep disturbance. Some children have difficulty falling asleep, or wake frequently, or have troubling dreams. You can give your child a stuffed animal, soft blanket, or flashlight to take to bed. Try spending extra time together in the evening, doing quiet activities or reading. Be patient. It may take a while before your child can sleep through the night again.

Helplessness. Let them know that it’s normal to feel scared or upset. Your child may also look to you for cues on how they should respond to traumatic events so let him or her see you dealing with symptoms of trauma in a positive way.

Alternative Medicine

Yoga, including Meditation, can be a lifesaving healing technique for trauma and PTSD patients. Yoga helps by addressing deeply ingrained stress in the body and mind. By releasing held tension through yoga postures, breathing exercises, meditation practices etc, physical and emotional trauma stored even at autonomic level can be released. A somatic approach helps ease the feelings of helplessness, fear, arousal, and disconnection that can arise for trauma patients. Meditation acts at CNS level.

Tai Chi. Also called Chinese Yoga, this has benefits similar to Yoga.

Marma Therapy. Marma Therapy has a great vata calming effect. Marma points act through changes in blood flow and levels of neurotransmitters in the brain and spinal cord. A good Marma Therapy plan can be very helpful.

Massage therapy. Yoga and Ayurvedic massages, based on Marma points, have wonderful relaxing and healing effect. Even western massages – deep tissue massage, or Swedish massage, can reduce your heart rate, relax your muscles, improve range of motion in your joints and increase production of your body’s natural painkillers. It often helps relieve stress and anxiety.

Homeopathy. Homeopaths claim amazing results in PTSD! In classical Homeopathy, treatment for chronic ailments is constitutional. For acute cases, especially in case of a holocaust or a natural disaster, using Genus Epidemicus may suffice. A few remedies will most likely be very frequently required for the majority of the population. In a case of a natural disaster, such as an earthquake or a hurricane, the majority of relatively healthy people are going to respond with the picture of a limited number of remedies, e.g., Arsenicum, Ignatia amara, Aconitum, Arnica, Stramonium etc. The response to the remedy is claimed to be very dramatic and satisfying to both the patient and the practitioner.

Prognosis

With proper therapy, prognosis for PTSD is good. It depends upon the severity and length of time a person has suffered from the disorder. Psychotherapy can change brain chemistry. There are significant risks to a person with PTSD if they do not receive treatment – they may stay in a hyper-aroused state, further damaging their brain. Irritability, anxiety, or numbness may interfere with their ability to love and to work. Suicide is also a risk with untreated PTSD.

Yoga and Ayurveda in Trauma, PTSD, Stress and Mental Health

PTSD fits the Ayurvedic understanding of vata invading majja dhatu and manovahasrotas (mind channels). After witnessing or experiencing the trauma, the individual develops a set of vata symptoms that include repeatedly re-experiencing the trauma. Hyperarousal is an important vata condition leading to disproportionate responses to stimuli, e.g., startling.

Watch for symptoms of vata ojo vyapat (invasion of vata into ojas), such as extreme fatigue, memory issues and reversal of the diurnal cycle (awake at night and sleeping during day). However, because the amygdala is involved with anger as well as fear, there may well be a strong pitta component or even pitta ojo vyapat. Appropriate diet and lifestyle suggestions should thus be individually tailored within the prakriti-vikritiparadigm. The usual triad of diet, lifestyle and herbal therapies form the mainstay of chikitsa; other treatment interventions include oil therapies and Vedic stress reduction techniques like yoga and meditation.

Less is more, this applies especially to PTSD clients. So, move slowly.

Panchakarma Therapy

Pre-purification Measures namely ‘snehan‘ and ‘swedan‘ are very useful to balance ‘Vata‘ and to loosen the toxins. Snehan is the herbalized oil massage. This oil is applied to the entire body with a particular type of massage. Swedan is sweating and is given immediately following the snehan. A herbal decoction may be added to the steam to further enhance effect. This also provides a deeply soothing and balancing effect to the entire nervous system. The motion of massage creates heat and friction which enhances circulation and helps cleanse.

Diet and Nutrition

Sattwik food is preferable. Rajasik food leads to more activity and tamasik food leads to an increase in greed, anger, etc. Most of vegetarian food is sattwik; you can start with decreasing the percentage of non-vegetarian food in your diet. Concept of xenohormesis also favors vegetarian diet.

Ashwagandha is always useful where there is vata in majja dhatu and is known to increase dopamine levels, mitigating the over-activation of the amygdala. Bacopa or Brahmi can be used to help regulate serotonin production and can be combined with other nervine and adaptogenic herbs. These should be taken under the guidance of an expert Ayurvedic physician. Some bhasmas, which are prepared on the principle of potentization, can also be used to strengthen ‘nerves’.

Marma Therapy and Yoga/ Ayurvedic Massages

Therapeutic Massages

Vata soothing oil therapies that are valuable in PTSD include abhyanga with dosha specific massage oil such as Vata Massage Oil and shirodhara using Shirodhara Oil which contains nervine herbs such as brahmi, Bhringaraj, Ashwagandha and skullcap. Shirodhara has been shown to help normalize serotonin and noradrenaline levels and reduce anxiety and is traditionally said to remove vata from majja dhatu. Sarvangadhara or pizhichil with sesame oil can also be used to calm vata and normalize majja dhatu. Also, specific Marma points can be used for achieving specific results.

Therapeutic Yoga in Trauma

Yoga has always had a lot to offer. I’ve always called it a science beyond nano-science! Yoga and Yoga-based practices (YBP’s) have sparked new activity in new scientific research and one sees evidence of so much new research coming out of study of YBP’s – newer theories, newer bodily mechanisms, newer approaches to therapy, newer explanations! Yoga-based interventions have been associated with measureable changes in physiological parameters, perceived emotional states, and cognitive functioning. The scientific community should be careful and diligent in placing the credit of all these newer finds where it actually belongs.

Effective treatment for PSTD is possible throughYoga Therapyand we offer world-class Yoga Therapy services at SAVY under Dr Jitender K Sahdev. The real route to PSTD recovery lies in non-drug approaches that act on nerves, brain through asana, pranayama, meditation etc. And that points to the real solution. Lifestyle, and mind-body approaches that help with PSTD have something in common – they all help restore a balance of neurotransmitters in the brain and central nervous system. They are not just as effective as medication, but almost always safer and much less expensive. Efforts should be made to increase the Sattvic quality of mind.

Research indicates that a healthy vagus nerve is vital in experiencing empathy and fostering social bonding, and it is crucial to our ability to observe, perceive, and make complex decisions. Areas of distribution of trigeminal nerve and pelvic splanchnic nerves may also be utilized to achieve the same purpose. Tests have revealed that people with impaired vagal activity have also been diagnosed with depression, panic disorders, Post Traumatic Stress Disorder (PTSD), irritable bowel syndrome, anxiety, panic disorders, violent mood swings, fibromyalgia, early Alzheimer’s and obesity.

Deep stretching is known to have a positive effect on PSTD. Some helpful poses are:

Tadasana,

Utkatasana

Sarvangsamasana

Halasana

Viparitakarni,

Bhujangasana,

Virbhadrasana,

Badha Konasana

Setubandhasana

Shavasana or Yoga Nidra

More of Vata reducing routines will be helpful. Regular practice of different postures should be done. Progressive deep relaxation, i.e., shavasana (corpse pose) brings about relaxation. At SAVY, we offer specialized TRY (SAVY Trauma Release Yoga) program specifically designed for PSTD.

are some of the exercises which can help in PSTD. All this must be undertaken strictly under proper guidance. Some clinical studies done in India have shown very positive results. Dr Sahdev’s Breathe and Heal Therapy, is one of the most effective and the safest breathing and mindfulness Yoga program specifically designed by a doctor for therapy.

Mudras

Hasta mudras attack the very root of problem; they address the issue of imbalance of five elements. Done for a minimum 45 minutes a day, they can be very effective.

These are some of the representative mudras:

Gyan Mudra

Vata-nashak Mudra

Anjali Mudra

Apana Mudra

Apana-Vayu Mudra

Prana Mudra

Shambhavi mudra, one kind of drishti, is very effective vagal stimulant. It should be learnt under an expert.

You should be able to notice the difference within a week. Mudras of the body, base, tongue, eyes etc form an integral part of our Yoga Therapy program. You can also join a specialized course on Hasta Mudras.

Meditation

Meditational therapies help the prefrontal cortex send calming messages to the amygdala. Both relative and absolute practices are important. Relative level practices may be more useful initially; relative practices include visualizations, affirmations, aspirations and relaxation practices. Visualizations work directly on the limbic brain and practices using words work on the prefrontal cortex. Visualization can include creating an image of a safe space and picturing oneself being there and relaxing. This sends messages of safety and relaxation to the limbic system. Affirmations can include positive phrases which help reprogram the prefrontal cortex to send healthy messages to the amygdala. Similarly, an aspiration practice can be used and combined with the breath. This practice helps the prefrontal cortex and limbic system to function normally. Once the mind is calmed by the use of relative practices, absolute practices such as vipashyana (mindfulness meditation) can be introduced. These practices help us see beyond the trauma by deepening our understanding of the impermanence of all phenomena. They have also been found to regulate prefrontal activity in favour of positive emotions.

Shatkarma

The six detoxifying procedures of Yoga:

Neti,

Dhauti,

Nauli,

Basti,

Kapaal Bhaati, and

Traatak

if done with proper technique, can be very helpful. Learn these under expert guidance at SAVY.

Lifestyle and Daily Routine

One of the most important factors is to have a lifestyle that does not disturb the natural body rhythm. When we eat, sleep and exercise in fluctuating and disturbing patterns, the body loses its natural cycle. Regularity in daily life can be extremely effective in reducing Vata imbalance. Expert Yoga Nutrition guidance is available at SAVY and should be availed.

TRY (SAVY Trauma Release Yoga)

SAVY offers this very effective and systematic approach for trauma, PTSD, stress and mental health. It teaches how to release deep chronic tension and stress, has immediate impact for most people, and can be integrated into a simple daily routine to help restore a sense of inner peace and emotional resilience. It is easy to learn and easy to practice. Benefits includes:

Stress/Anxiety/Trauma/ Depression Relief

Better emotional resilience

Easing of neck/ shoulder/ low back pain or tension

These techniques induce healing at the deepest levels of body and mind.

If you have genuine interest in helping and empowering people with health issues, this program is especially for you!

Click on the image below to know details:

HEALING THROUGH BREATHING

NATURAL, SAFE, DRUG-FREE, EFFECTIVE

Note : DSBH Therapy ®, MBH Therapy® or TRY® has not been evaluated by Health Canada, US Food & Drug Administration or the American Medical Association. This technology does not claim to diagnose, treat, cure, or prevent any disease. Medical advice must only be obtained from a physician or qualified health practitioner. Results may vary between individuals. There are no guarantees, expressed, or implied.

You should check with your health care professional before starting this or any new therapy or exercise program or breathing routine. This is especially important if you have any pre-existing health conditions, such as high blood pressure, migraines or heart or lung ailments. Women who are pregnant or think they might be pregnant should consult their physician before performing any of the breathing or physical exercises or undertaking any therapy program.

The information contained in the program is not intended to serve as a replacement for professional medical advice. Any use of the information in these programs/ workshops is at the reader’s discretion, risk and responsibility. The studio, author and the publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained herein. A health care professional should be consulted regarding your specific situation.

(We provide YTT in Yoga Retreats all around the world also)

If you have genuine interest in helping and empowering people with health issues, this program is especially for you!

DSBH Therapy Educator program is meant to provide training in DSBH Therapy. Based on Pranayama, the science of breathing, and Dhyana, meditation, it is a well-structured, stepped and safe program. This equips DSBH Breathing Educators with tools to impart knowledge of safe and effective therapeutic breathing exercises to those who actually need it.

Based on effective breathing and other Yoga techniques, validated by the stringent test of time and the millions who tried them, and backed and refined by Dr Sahdev’s almost three decades of superlative clinical experience at the fore-front of main-stream Medicine, these breathing and other techniques havebeen proved to actually deliver!

This is the science of the future!

Benefits of this program include:

Learn Breathing and Mindfulness techniques effective in more than 90% of diseases

Improvement in your own health

Career growth – advance in your career to next levels

Outstanding education, training and supervision of a cutting-edge therapy in the new, growing field of breath-work

Availability of exclusive reading material

Virtual literature available for your clients

Access to a website master for the creation of your own website

Ongoing support for your professional development

On-going continuing education opportunities

You can register now for DBE-MBH training program.

This program is unique by virtue of its:

focus – which is therapeutic effect of breathing exercises and other yogic elements,

depth and expanse – meant to address even the most deep-seated, intractable and chronic problems,

clarity – because of division into levels, all ambiguity has been done away with; you don`t go to the next level till you are ready,

applicability – it`s universally applicable; you go up the ladder as you advance, and

has a profound Yogic as well as medical base.

It contains some of the most potent and most effective therapeutic breathing exercises. Applied judiciously, this program has enormous healing potential!

Dr Jitender K Sahdev, the founder of the method, is a qualified Physician from India, has done MD, Ph.D. and D.Sc. in Alternative Medicine in India, and is an E-RYT 500Yoga Teacher and a Yoga Therapist in North America. He is one of the very few people in the world who are experientially as well as academically so well-equipped.

DSBH Therapy Educator program is the First Truly Canadian Breathing Educator Program, to train educators for DSBH Therapy – the First Truly Canadian Yogic Breathing Exercises program designed for therapy.

Utthitta Chaturanga Dandasana (Plank): This pose will give you a toned belly, reduced back pain, flexibility, will improve your mood and gives you an improved balance and posture. Start from 30 seconds and build up.

Chaturanga Dandasana (Four Limbed Staff Pose): Use the strength of your whole body to do this pose. This is much more than a push-up. It strengthens arm, shoulder, and leg muscles, develops core stability and prepares body for inversions and arm balances.

Tripada Chakrasana (Three-legged Wheel Pose): Need an energy boost? Do this pose. It stretches the chest and expands lungs, strengthens the arms and wrists, legs, buttocks, abdomen, and spine, stimulates the thyroid and pituitary, increases energy and counteracts depression, and is therapeutic for asthma, back pain, infertility, and osteoporosis.

Halasana (Plow Pose): This pose strengthens and opens up the neck, shoulders, abs and back muscles, calms the nervous system, reduces stress and fatigue, tones the legs, stimulates the thyroid gland, strengthens the immune system and also helps women during menopause.

Bakasana (Crow/ Crane Pose): Bakasanahelps in strengthening the wrists and arms, stretches the upper back and increases the flexibility and elasticity of the spine, strengthens and tones various muscles and organs in the abdominal region, opens up the groin region, and improves the sense of balance, concentration, and co-ordination.

Ashtavakrasana (Eight-Angle Pose): This pose is dedicated to the sage Ashtavakra, the spiritual guru of King Janaka. This difficult lateral movement tones the spine by supplying the spinal nerves with a copious supply of blood. It increases gastric activity, helps to digest food and eliminate toxins. The spine is given the maximum lateral twist.

Thursday – Relevance and History

Thursday is dedicated to Lord Vishnu and Lord Brihaspati, the Guru of gods. Hence, this day is called Brihaspativar. Thursday is also popularly known as Guruvar. Devotees listen to devotional songs dedicated to Lord Vishnu on this day.

Devotees fast throughout the day and consume food only once which consists of ‘chana daal’ (Bengal Gram) and ‘ghee’ (clarified butter). The food color used is yellow. Many offer banana or plantain to god. In Bengal, they worship goddess Lakshmi and elsewhere, people also visit Hanuman temples on Thursdays. Through ‘pujas’ (worship) and ‘vrats’ (fast) on Thursdays, it is believed, devotees are blessed with wealth, success, fame, and happiness.

Folklore:

The popular myth is that Lord Vishnu once appears before a devout Hindu disguised as a beggar to test the devotee on a Thursday. Some believe it was Lord Vrihaspati. At first the devotee neglects his duties towards the holy man and denies him alms and is lethargic but later when he realizes his mistake, he observes a ritual fast on Thursdays and appeases the gods.

Color & Gem:

Yellow is the color of the day and the preferred gems are Sapphire and Pukhraj.

Celestial Body:

The planet Jupiter (Vrihaspati) rules Thursday.

To see the full schedule, please click here and check schedule of classes.

The salient features of London Yoga Classes at SAVY are:

Comprehensive, authentic, world class teaching and knowledge-base in all aspects of Classical Yoga

Continuous yoga practice helps fight your blues as well as to explore and direct life in a better way. Time invested in practicing these yoga poses daily will set your spirits high for a lifetime.

Here are some yoga poses to beat the Monday morning blues.

Viparita Karani (Legs up the wall pose): Lie down on the floor and raise legs at vertical, against a wall. Without the use of a wall support this posture looks a little like supported shoulder stand. This posture helps the mind to be in present moment which helps in coming out of foul moods and blues.

Virbhadrasana I (Warrior I): It is essentially a balancing pose which also expands the chest region and shoulders. It is a very good posture to relieve stress. Expanding chest region brings the sense of happiness, which ultimately takes you out of the gloom. Warrior II and Warrior III also achieve the same purpose.

Adho Mukh Svanasana (downward facing dog pose): This posture works as an anti-depressant and is one of the poses in traditional sun salutation. It also frees sciatic nerve. This pose supports your head and forces you to be in present moment by engaging you on all four limbs.

Parsarita Padottanasana (Wide legged forward bend): This posture plays a vital role in calming the brain. It brings a feeling of support and lets you feel free at the same time when you feel lonely.

Salamba Shirshasan (Supported Head stand): Also called the King of Yoga Poses, this is an inversion posture, where in with the support of your hands, you stand on your head upside down. This posture requires a lot of focus hence keeping the mind in present moment. It’s a therapeutic posture for mild depression and insomnia. It also calms the mind and relieves the stress.

Salamba Sarvangasamasana (Supported Shoulder Stand): It is an inverted pose, and it engages all parts of the body. With the support of the shoulders the entire body from the torso is taken upwards and is balanced straight. This posture relieves stress and depression.

Shalabhasana (Locust Pose): This pose is very interesting and challenging pose. It helps in relieving stress and uplifts your mood instantly.

Chakrasana (Wheel Pose): This is a chest opener pose. Chest opener poses helps in relieving stress, and heart is flooded with space and light, making us feel better. All we have to do is just sit the opposite way we sit when we are sad – shoulders square, chest expanded, head held high.

Practice these poses regularly.

Monday – Yoga Relevance and History

Monday is dedicated to Lord Shiva, the Adi Yogi or the First Yogi, who gave the gift of Yoga to humanity. On this day, he is worshipped along with his consort goddess Parvati. Though, of course, as is the custom, Lord Ganesha is venerated right at the beginning of the worship. Devotees also listen to Shiva Bhajans on this day.

Ritual:

The ‘Somvar Vrat’ or Monday fast is observed from sunrise till sunset and the devotee partakes of the food only after saying his evening prayer. Fasting on Mondays in the month of Shravan is considered even more auspicious. Hindus believe that observing a fast or ‘upvaas’ on Mondays will satisfy Lord Shiva who will grant them wisdom and fulfill all their desires. In some places, unmarried girls and spinsters keep fast to be blessed with an ideal husband.

Folklore:

This tradition goes back to Hindu mythology, though the myths vary greatly from region to region. One popular one is that there lived a very poor Brahmin who started devoting his Mondays to fasting and worshipping Lord Shiva. After a period of time, the Lord was satisfied with his devotion and blessed him with wealth. Another lore speaks of a rich merchant who begets a son after a prolonged wait but the child dies. It is only with the grace of Lord Shiva and Parvati that the son is reborn. A third story is describes a game of dice played between Shiva and Parvati that makes Monday important for Shiva.

Color & Gem:

White is the preferred color of the day and Pearl the preferred gem.

Celestial Body:

The Moon (Chandra) rules Monday.

To see the full schedule, please click here and check schedule for different locations.

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Announcing Two New SAVY Yoga Studios

Congratulations London!

With your patronage, love and kind support, SAVY Yoga has been growing from strength to strength since its inception in 2011.

Conceived to be an island of excellence for Yoga, Yoga Teacher Training, Yoga Therapy and related branches , SAVY has always strived to bring the best in traditional Yoga to you, in all its potential and enormity, at the South London SAVY Yoga Studio on Exeter Road.

At SAVY, Yoga is not just another exercise form; it’s a potent tool not only to stay healthy, but also to regain health if any component of health gets compromised.

In this calm, serene family neighbourhood, we are offering Small Class Yoga and Private Classes at this location.

This will also be operational from April 16, 2014.

To get your Inaugural Small Class Yoga Offer at this location, click here!

The South LondonSAVY Yoga Studio on Exeter Road will continue to be fully operational.

Under one of the most qualified faculty in North America, expect some real quality Yoga!

With the South London SAVY Yoga Studio and these two added locations, three locations in London in toto, we rededicate ourselves to the health and wellness of people of London ON specifically, and people of rest of the world in general!

Thank you London!

Dr Jitender K Sahdev

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Vinyasa Yoga Classes

This class has been structured for those who have done SAVY Yoga before and are not afraid of trying a little more difficult yogic postures. The good thing about yoga system is that there is something for everybody regardless of body weight, physical limitations/strength or flexibility. This class is about Yoga in flow! So, it is imperative that the students have learnt the routine of B II level class thoroughly. With the regular practice of those movements they would be amazed to see how the yoga practice is helping them in making a difference in their lives. This class is in 60 minute format.

This is a vibrant mix of postures aimed at gaining strength, flexibility and removing stress in the mind. SAVY provides a loving, nurturing and inspiring environment where all feel welcome and comfortable in the class. Whether you are a complete beginner, or a seasoned yogi, our class will invigorate the mind, body and soul.

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Nabho Mudra in Dr Sahdev’s ‘Breathe and Heal’ Program

Nabho Mudra

Nabho Mudra involves the tongue touching the palate and is somewhat similar to Khechari mudra in its action. Nabho mudra is mentioned in Gheranda Samhita and is practiced by meditators from various traditions.Nabho mudra is an easy form of KhechariMudra, which is mentioned in Hatha Yoga Pradipika, and can be easily practised by anyone.

In Gheranda Samhita, Nabho Mudra is described as a practice where the practitioner turns the tongue upwards to meet the palate and then retains the breath. The text says that one can also do this during all activities like sitting, walking, etc.

Nabho Mudra or Simple/ Small Khechari – which Gheranda Samhita claims can remove all disease and suffering of the Yogi, forms an integral part of Dr Sahdev’s ‘Breathe and Heal’ Program, a scientifically and yogically correct and very effective breathing and meditation routine, full of possibilities. In Sanskrit, ‘Nabho’ means ‘space or heavens or sky’ and mudra means ‘posture’. So, literally it can be translated as ‘Space or Heavens or Sky Posture’. Mudras are the postures and act as smaller body locks for energy. Mahatma Budha also made use of Nabho mudra and Vipashyana, now more popular as Vipassana (Pali language), during meditation.

The breadth and depth of understanding and knowledge from the Vedas and other classical Yoga books from thousands of years ago is just astounding, overwhelming, breath-taking and divine! In this modern era, we have just begun to understand this unfathomable sea of knowledge, handed down from generation to generation in a few brief and concise verses, and experiential practices. The full potential of all this knowledge in physical, mental, metaphysical and spiritual dimensions can be comprehended by a devout, practising yoga practitioner through regular practice only.

Nabho Mudra is simple, more of a Raja Yoga practice. Khechari Mudra, a more profound, practice, done in Hatha Yoga, involves taking the tongue all the way back to reach the nasal cavity. Traditional Hatha Yoga is intended to lead to Raja Yoga, the ‘Royal Yoga’, the goal of which is the highest state of consciousness known as Samadhi. Khechari is done with a lot of effort like milking the tongue and sometimes even cutting the frenulum of the tongue to free it. Once it is able to reach the nasal cavity, it can then be extended to the roof of the cavity. By stimulating certain regions of the cavity with the tongue, the yogi gets the benefit of amrita or nectar, as per Hatha Yoga Pradipika. Through this nectar, the yogi rejuvenates his body and attains long and healthy life. Whether this nectar is a physical secretion, or modulation of secretions from the master and other glands, is yet to be ascertained.

Many masters say that cutting the frenulum for Khechari is unnecessary and the same results can be gained through constant practice of Nabho Mudra. It is said that during certain stages of meditation, the tongue automatically goes and touches the roof of the palate. By constant practice, the tongue can go further back towards the throat, till it touches the uvula at the back. Finally it can be made to enter the nasal cavity. This takes years of practice.

This mudra was kept a well-guarded secret for thousands of years, and very correctly so. Nabho and Khechari take the Yogi a step closer to gaining full control over the processes of the physical body. It is an old technique to achieve peace of mind and to facilitate a state of silent and deep meditation, and hence achieving the highest state of samadhi or contemplation. Talavyaor Talabhya Kriya (‘Talu‘ means palate; ‘Talavya‘ or ‘Talabhya‘ means related to palate) is the preparatory exercise to advance to a perfect Khechari Mudra. It must be learnt directly from a physical ‘Guru‘ and should only be practiced under direct supervision of the Guru. It takes a lot of practice to learn and to do accurately even when explained properly and correctly, and it must not be attempted except under expert guidance of a learned ‘Guru’ or teacher after understanding the procedure correctly. That is more because of what these mudras are capable of rather than just the procedures. Preliminary, preparatory procedures and training in ‘Talabhya Kriya’ and other procedures are essential for serious exponents of Yoga. Amateurish attempts at this may lead to many complications. However, very simple or initial versions can be explained and understood easily and can be taught even to non-yogis and not-so-advanced yogis.

Nabho Mudra can also be considered an easier option to the practice of full Khechari mudra. Though it remains to be documented medically, but clinically and in traditional Yoga practices, many different types of diseases, even intractable ones, have been found to resolve by the practice of this mudra.

As a Sanskrit verse explains about Nabho Mudra:

यत्रयत्रस्थितोंयोगीसर्वकार्येषुसर्वदा।

उर्ध्वजिव्ह: स्थिरोभूत्वाधारयेत्मवनंसदा।

नभोमुद्रामवेदुषायोद्विनारोगनाशिनी।।

Yatra yatra sthitom yogi sarvakaryeshu sarvada

Urdhvajivha sthiro bhutvadharyetmavanam sada

Nabhomudra mavedusha yogvina roga nashini

Meaning

The yogi, who stays constant in all aspects at all times, controls the breath

When the yogi now curls his tongue upward and back, he is able to, close the place where the three paths meet. The bending back of the tongue is khechari mudra and closes the three paths in akasha chakra. The yogi who remains but half a minute in this position is free from illness, old age and death. He who has mastered khechari mudra is not afflicted with disease, death, laziness, hunger, thirst and swooning. (HYP 8: 32-39)

Daily he may eat the flesh of the cow and drink wine. The word go (cow) in Vedic language means tongue; eating it is to thrust it into the gullet, which produces heat in the body causing nectar to flow out of the moon (chandra nadi) situated on the left side of the eyebrow centre, also called ida nadi, and that is called drinking wine. (HYP 8: 47-49)

Gherand Samhita states:

The body becomes beautiful; samadhi is attained, and the tongue touching the holes in the roof of the mouth obtains various juices – first he experiences a saltish taste, through alkaline to bitter then astringent, then he feels the taste of butter then ghee, then of milk, then of curds, then of whey, then of honey, then of palm juice, and lastly arises the taste of nectar. (GS iii, 30-32)

Procedure

It must be learnt and practised only under an expert guidance. It is explained here as a reference for the benefit of those who are learning under an expert teacher.

Sit in any of the Yogic sitting postures such as Padmasana, Sukhasana, Vajrasana, sitting in a chair or in stand-at-ease position. Initially, it is prudent to choose one of the sitting postures.

Padmasana

A correct and easy way of doing Nabho Mudra is by putting the tongue up against the palate, with the tip of the tongue touching between back of your teeth and hard palate, and tongue pressing against the hard palate, and keeping it there for as long as you can do it comfortably. More advanced techniques give access to varied functions.

Palate

Nabho Mudra-Breathe and Heal

Nabho Mudra

A correct and easy way of doing first level of Khechari Mudra is to put the tip of the tongue against the soft palate, behind the hard palate. For this, the tongue has to be turned upside down, bringing the undersurface of the tongue up, and touching the tip of the tongue with the soft palate. Keep it there for as long as you can. If you feel uncomfortable or feel pain, unroll your tongue and relax for a few seconds and again resume. Build up your practice slowly. A low protein diet helps advancing in this process, as does singhasana (the lion pose).

Khechari Mudra Level I

Khechari

Also, at the same time, you should be doing Shambhavi mudra – keep the eyesight in the middle of both the eyebrows, at Aagya Chakra. It’s more easily done with eyes closed.

The correct and complete practice of Nabho Mudra is achieved only when your eyesight is between both the eyebrows, in Shambhavi Mudra, and your tongue is in contact with the palate. Both of these should be accomplished together at one time.

Also, Nabho Mudra can be practiced with Pranayama. Gheranda Samhita also instructs about retaining the breath during this practice. That is optional during meditation. During meditation, the breath naturally slows down. During deeper states, one may experience natural suspension of breath for a few minutes. This is called Kevala kumbhaka. Forcing Kevala Kumbhak is unnecessary and undesirable.

Understanding the Action of Nabho Mudra

Though explanation of the full effects and the actions of this simple, and to many seemingly illogical and unscientific, yogic procedure or pose is beyond the scope of this article, yet we can make an attempt to understand basic mechanism of some of the leading physical effects of Nabho Mudra, and to some extent, Khechari Mudra.

During Nabho mudra the tongue is fixed in one spot touching the palate. When the tongue doesn’t move, the onslaught of thoughts also decreases naturally. Thoughts may still occur, but only minimally. This principle is of great help in meditation. Instead of fighting with thoughts, just use Nabho mudra to get substantial help to reduce thoughts per minute.

In Yogic terms, we understand that the cosmic or prana energy can flow through the Sushumna nadi and nourish the entire body. This flow may be interrupted at the region of the throat. The prana energy flows from Vishudhi Chakra to organs of speech.

If the flow of prana energy is obstructed or is obliterated, this may cause or contribute towards the instability or distractibility of the mind. Nabho mudra connects that prana energy directly to the next energy centre, i.e., Aagya Chakra, through various marma points. Thus, it helps bypass the normal route and encourages freer flow of prana. Placing the tongue against the palate is one way to bypass this blockage. This reconnection tends to calm the mind and leads to attainment of eternal bliss. This depends on the point of contact – the alveolar groove, the hard palate, the soft palate, the epiglottis, the nares, etc.; the tongue gets connected to various nadis, or energy channels, by touching marma points. Just by putting your tongue up, you can use Nabho mudra to connect the front and back channels of your body which prevents build up of too much pitta or heat. Nabho mudra can also be used to passively conduct energy flow to various upper centers and marmas (bindu, sahasrara, aagya, sthapani, simanta, etc.).

When practising routines that arouse kundalini, it is one of three safety factors that prevent ‘burn out’ in the head region, while still allowing flow of cooler energy through the crown, the third eye, and all of the associated bindus. The other two safety factors are a fully relaxed jaw release, and a suspended head position, which is said to release krikatika marma.

Medically speaking, our body responds to any kind of threat by the ‘fight or flight’ response.

In either case, sympathetic nervous system kicks in and it leads to a rise in blood pressure, in addition to other phenomena. Tension and stress of daily living are also perceived by the body as a danger signal and have the same physiology, and the body responds through the stimulation of the sympathetic nervous system.

The sensory nerves from the tongue to the brain, are branches of the trigeminal, facial, glossopharyngeal and vagus nerves; all of these, except the trigeminal, are linked to the parasympathetic component of the autonomic nervous system.

Thus, through the practice of Nabho or Khechari Mudra, we stimulate these nerves which are concerned with relaxation and also monitor taste, secretion of the different salivary glands, respiration, and so on. Through the parasympathetic nervous system, we also gain access to the hypothalamus and the endocrine glands. A side effect of using Nabho or Khechari mudra in the quest for higher consciousness is the regulation of the endocrine system, especially the pituitary gland. Nabho or Khechari allow us to control thirst and hunger. Through more advanced practices, Yogis learn to get conscious control over regulation of brain centres for blood pressure, temperature, respiration etc.

Also, body mechanisms including Carotid sinuses help to control and regulate blood pressure.

Carotid sinuses are two remarkable organs situated at the bifurcation of the carotid artery on each side, in front of the neck and just below the level of the jaws, at the level of the thyroid cartilage or Adam’s apple. The carotid sinuses contain numerous baroreceptors which function as a “sampling area” for many homeostatic mechanisms for maintaining blood pressure. The carotid sinus baroreceptors are innervated by the sinus nerve of Hering, which is a branch of the IX cranial nerve . The glossopharyngeal nerve makes synapses in the nucleus tractus solitarii (NTS) located in the medulla oblongata of the brainstem. The NTS indirectly modulates the activity of sympathetic and parasympathetic (vagal) neurons in the medulla and pons through the hypothalamus. These neurons then regulate the autonomic control of the heart and blood vessels.

The brain responds immediately to such a stimulus by adjusting the heart rate and contraction of the arterioles, thus correspondingly adjusting the blood pressure to keep it within normal range.

Thus, Nabho mudra, in very mechanistic terms, acts by virtue of the anatomical proximity of the root of the tongue to the carotid sinuses in the neck and through access to the parasympathetic nervous system through the nerves supplying tongue. The pull at the root of the tongue acts by applying a subtle drag on these sinuses in the neck, causing them to react as though they have detected high blood pressure, with the result that the heartbeat and the blood pressure decrease. This leads to relief in stress response and overall physical and mental relaxation.

These carotid sinuses as well as the sinus nerves were well known in ancient times. Shiva Samhita says: “Stop the flow of the vigyana nadis (sinus nerves) with the second fingers. This gives siddhi (power or control attained by a Yogi through practice) in the form of happiness and bliss.”

The implications of the above verses are obvious: if you gently press these carotid sinuses then you will become very relaxed and perhaps a little faint. This can help in various other yogic practices that lead to meditation. But all this must not be tried by an uninitiated person or except under guidance and supervision.

Sira Matrika Marmas described in Sushruta Samhita correspond with the position of carotid sinuses. In the science of Marmani Chikitsa or Marma Therapy, there are five types of Marmas on the basis of consequences, in which one type is Sadyapranahara Marma, that means injury to these Marma leads to sudden death. Sira Matrika Marmas are eight in number, lie in the neck on either side of Kanthnadi between Nila and Manya Marmas, along the carotid artery. These are Sadyapranahara Marmas.

Kalaripayattu is one of the oldest fighting systems in the world and is called the mother of martial arts. (Malayalam and Tamil, kalari: school or gymnasium, payattu: to fight or to exercise or to put hard work into. In Sanskrit, ‘Khalurika’ means parade ground or arena, and ‘payas’ means power or strength, or ‘pasi‘ meaning spear) In this martial art, site corresponding to sira matrika is considered one of the death-causing marmani.

In acupuncture, an offspring of Marmani Chikitsa, the point renyingor Stomach 9 corresponds to the location of Sira Matrika Marma. The same point is used in acupressure also.

In Dim Mak or Kyoshu Jitsu, renying is considered one of the killer points.This point is also used to subdue the opponent in karateand krav maga.

As explained in the video below, carotid sinus massage is a useful procedure in Medicine too:

Benefits

Nabho mudra is a very simple practice but it has many subtle influences on the health of body and brain.

It helps modulate the parasympathetic system which leads to a state of relaxation, and results in immediate calmness of the mind and body.

Nabho Mudra has a profound effect on diseases of heart, lungs and brain and helps overcome insomnia, anxiety, high blood pressure, diseases of tongue, throat, eyes and is especially beneficial in all stress – related or psychosomatic diseases.

In conjunction with breathing exercises, mudras and procedures, this can influence health very positively and can help overcome diseases.

When the tongue is inserted into the nasal cavity in Khechari Mudra, many small nerves and glands are activated, thereby increasing the autonomous control of the body.

It is also said to decalcify the pineal gland, which plays an important role in spiritual awakening.

The Head of Faculty – Dr Jitender K Sahdev, in addition to being a Physician in Modern Medicine from India, is a Yoga Therapist, Yoga Teacher and Ayurveda Practitioner par excellence in London with over 51,000 hours of Traditional Yoga teaching experience and almost three decades of experience in Modern Medicine, Ayurveda, Yoga Therapy and other alternative treatment modalities. He utilizes Ayurveda and Yoga as stand-alone as well as complementary therapies for optimizing the health and wellness of his clients, for easing symptoms associated with disease, and more. He trained under doyens of Yoga in India for almost four decades.

Note : Yoga Therapy is best administered in an individualized manner though some generalized guidelines have been provided for all. You should check with your health care professional before starting this or any new therapy or exercise program or breathing routine. This is especially important if you have any pre-existing health conditions, such as high blood pressure, migraines or heart or lung ailments. Women who are pregnant or think they might be pregnant should consult their physician before performing any of the breathing or physical exercises or undertaking any therapy program.

The information contained in the program is not intended to serve as a replacement for professional medical advice. Any use of the information in these programs/ workshops is at the reader’s discretion, risk and responsibility. The studio, author and the publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained herein. A health care professional should be consulted regarding your specific situation.

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